cefoxitin + cefotaxime + metronidazole

A multi-drug antibiotic regimen investigated by Asan Medical Center for the prevention of surgical site infections (SSI) in patients undergoing pancreatoduodenectomy. The regimen involves a sequential approach: a single preoperative dose of cefoxitin (a second-generation cephamycin) followed by a three-day postoperative course of cefotaxime (a third-generation cephalosporin) and metronidazole (a nitroimidazole). The cephalosporins function by inhibiting penicillin-binding proteins (PBPs), which are essential for bacterial cell wall synthesis, leading to cell lysis. Metronidazole provides anaerobic coverage by being reduced to active intermediates that cause DNA strand breakage and inhibit nucleic acid synthesis. This prolonged prophylaxis strategy is currently being compared against standard single-dose cefazolin in a Phase III clinical trial to evaluate its impact on reducing postoperative infectious complications in high-risk pancreatic surgery.

Other names

Prolonged perioperative antibioticscefoxitin followed by cefotaxime and metronidazole